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Agda Marobo Andreotti, Marcelo Coelho Goiato, Amália Moreno, Adhara Smith Nobrega, Aldiéris Alves Pesqueira, Daniela Micheline dos Santos Araçatuba Dental School, São Paulo State University, Araçatuba, São Paulo, Brazil Abstract: The aim of this study was to assess the effect of adding nanoparticles to N1 acrylic resin intended for artificial sclera, in terms of the color stability, microhardness, and flexural strength of the resin. Three hundred samples of N1 acrylic resin were used: 100 samples for color stability and microhardness tests (each test was performed on the opposite side of each sample), and 200 samples for flexural strength testing (100 samples before and after 1,008 hours of accelerated aging). Samples for each test were separated into ten groups (n=10), ie, without nanoparticles (control group) or with nanoparticles of zinc oxide, titanium dioxide (TiO2), and barium sulfate at weight concentrations of 1%, 2%, and 2.5% (nanoparticle groups). Data were subjected to statistical analysis with nested analysis of variance and Tukey’s test (P

Background: Considering the development of new 3D printing technologies that use different printing techniques, further studies must be conducted to evaluate the impact of different printing systems on the mechanical properties of 3D-printed materials. This study aimed to evaluate the mechanical properties of 3D-printed materials for occlusal devices using different 3D printers and printing layer thicknesses., Material and Methods: Ninety rectangular samples were manufactured and divided into nine groups according to the 3D printer model they were printed on (AnyCubic Mono X, Elegoo Mars 2, or FlashForge Hunter) and the layer thickness (20, 50, or 100 µm) and were subjected to superficial microhardness, flexural resistance, and elasticity modulus tests. The results were analyzed using two-way analysis of variance and Tukey's statistical tests, with a significance level of 5%., Results: The type of 3D printer significantly affected superficial microhardness ( p = 0.007). Flexural strength showed a significant interaction between the 3D printer and layer thickness ( p = 0.005), with both factors independently influencing flexural strength (printer: p < 0.001, layer thickness: p < 0.001). Elasticity modulus was significantly influenced by the 3D printer type ( p < 0.001) and the interaction between both factors ( p = 0.004). The AnyCubic Mono X 3D printer with a 20 µm layer thickness exhibited more consistent mechanical properties than the other printers., Conclusions: Variations in printing systems and layer thicknesses can impact the mechanical properties of 3D-printed materials. Key words: CAD-CAM. Bruxism. Temporomandibular disorders. Mechanical tests; 3-D printing.Care Team., Competing Interests: Declared none., (Copyright: © 2024 Medicina Oral S.L.)

Objectives: This study aimed to assess the influence of translucent monolithic versus bilayered crowns and whether the use of a CoCr base abutments affects the fatigue and fracture resistance of screwed implant-supported single crowns with external connections under mechanical cycling., Materials and Methods: Fifty specimens were divided into groups: (1) metal-ceramic (MC) crown, (2) veneered zirconia crown (Zr), (3) veneered zirconia crown with a CoCr base abutment (ZrB), (4) monolithic translucent zirconia crown (MZr), and (5) monolithic translucent zirconia crown with a CoCr base abutment (MZrB). Specimens underwent mechanical cycling (5 × 10 6 cycles; 150 N) evaluating fatigue resistance (number of failures) and those that failed were subsequently subjected to fractographic analyses (stereomicroscope and scanning electron microscope) to evaluate failure location and area, and maximum fracture load was also measured., Results: The failure-related survival rate (100%) and maximum fracture resistance of the MZrB were significantly higher than those of MC and Zr (50%; p < 0.05). There were no significant differences in the failure rate and fracture resistance when a CoCr base abutment was used or not in the translucent monolithic Zr groups (p > 0.05;MZrB vs. MZr). Failure location, with MC crowns' fractures, noted at the screw area (p = 0.043), while all-ceramic crowns were mostly in the cuspid and to failure area, the Zr group had the largest mean (15.55 ± 9.17 mm 2 ) among the groups, significant difference only when compared with MC (1.62 ± 0.81 mm 2 ) (p = 0.025)., Conclusions: Translucent monolithic zirconia crowns exhibited significantly higher fatigue and fracture resistance compared with conventional MC and bilayered crowns., Clinical Significance: The appropriate choice of material and manufacturing technique is crucial for predicting the higher clinical performance of single crowns. Enhanced mechanical resistance in terms of fatigue and fracture resistance can be achieved by replacing MC and bilayered restorations with computer-aided design and computer-aided manufacturing monolithic zirconia., (© 2024 Wiley Periodicals LLC.)

Background: The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane treatment for bonding lithium disilicate ceramics., Material and Methods: The formulated PICO question for this research was: "Does self-etching silane primer surface treatment in lithium disilicate ceramics present a similar bond strength value compared to conventional hydrofluoric acid and silane treatment?". Combinations of words and appropriate truncations were adapted for each database. For the selection, duplicate articles were systematically eliminated using Mendeley software. The Cohen's Kappa statistic was then computed, RoBDEMAT questions were addressed, and the meta-analyses were conducted using RevMan 5.4, at a significance level of 5%., Results: Two independent reviewers conducted a blind and independent analysis of 190219 articles from PubMed, Scopus, Web of Science, and OpenGrey. Subsequently, they extracted data from 21 studies for the systematic review and in 16 the meta-analysis. In all in vitro studies, the most frequently cited concentration of hydrofluoric acid was 5%. In the meta-analysis, no statistical differences were observed between the two treatments concerning bond strength., Conclusions: Self-etching silane primers demonstrate promising results in lithium disilicate bonding, suggesting their potential as an alternative surface treatment to hydrofluoric acids + silane. Key words: Lithium disilicate, Hydrofluoric acid, Dental Porcelain, Ceramics, Silanes., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright: © 2024 Medicina Oral S.L.)

Statement of Problem: Surface treatments for resin-ceramics have been developed to obtain a smooth surface and improve color stability. However, a consensus on the best treatment for these materials is lacking., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the color stability and roughness of glass-ceramics versus resin-ceramics with different surface treatments., Material and Methods: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed, and the study was registered in the open science framework (OSF) for in vitro studies. The population, intervention, control, and outcome (PICO) question was "Is there a difference in color stability and roughness between resin-ceramic vs vitreous ceramics in different surface treatment protocols?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases up to January 2023. The Joanna Briggs Institute's critical assessment guidelines for quasi-experimental studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (α=.05)., Results: A total of 18 laboratory studies were published between 2015 and 2022, with a total of 2160 specimens, all of which were analyzed qualitatively. The meta-analysis indicated significantly less optical alteration for lithium disilicate ceramics (P<.01; MD: 2.69; 95% CI: 2.00-3.39; I²=89%, P<.01), even when compared with resin-ceramics with polish or sealants (P<.01; MD: 2.45; 95% CI: 1.59-3.30; I²=87%, P<.01) and (P<.01; MD: 3.24; 95% CI: 2.02-4.47; I²=89%, P<.01), while there was no significant difference in surface roughness (P=.08; MD: -0.71; CI 95%: -1.52 to 0.09; I²=87%, P<.01) (P=.33; MD: -0.31; CI 95%: -0.94 to 0.32; I²=87%, P<.01), respectively., Conclusions: Resin-ceramics that have been polished or treated with sealants have lower color stability than glazed glass-ceramics; however, they are similar in terms of surface roughness., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Polyetheretherketone (PEEK) resin is a high-performance thermoplastic polymer that has been introduced as a possible candidate to replace metallic components in dental prostheses. The objective of this integrative review was to compare, through analysis of studies in the literature, the mechanical performance of removable partial denture frameworks and clasps manufactured with PEEK with the performance of cobalt-chromium (Co-Cr) frameworks and clasps. The guiding question was, "Does the use of PEEK as a substitute for Co-Cr alloys for the construction of removable partial denture frameworks result in better mechanical properties?" The PubMed/ MEDLINE, Embase, Web of Science, Scopus, and SciELO databases were searched for articles published through October 2021. The JBI Critical Appraisal Checklist for Quasi-Experimental Studies was used to assess the methodologic quality of the selected in vitro studies. A total of 208 articles were identified. After the exclusion of duplicates and articles that did not meet the inclusion criteria, 7 studies- -4 in vitro and 3 three-dimensional finite element analyses- -published between 2012 and 2021 were included in the integrative review. The appraisal checklist revealed that the reviewed studies had a low risk of bias and high methodologic quality. The results of the review showed that PEEK alloys have adequate mechanical properties for use in clasps and removable partial denture frameworks, but Co-Cr alloys exhibit better mechanical properties and are more suitable in most circumstances., Competing Interests: No conflicts of interest reported.

This study aimed to compare the mechanical properties of various occlusal plate materials by analyzing surface roughness, Knoop microhardness, flexural strength, and modulus of elasticity. Fifty samples were prepared and classified as SC (self-curing acrylic resin), WB (heat-cured acrylic resin), ME (acrylic resin polymerized by microwave energy), P (resin print), and M (polymethylmethacrylate polymer block for computer-aided design/computer-aided manufacturing). The data were analyzed using a one-way analysis of variance and Tukey's honestly significant difference test. Surface roughness was the same in all groups. The surface hardness of group M was statistically superior. The samples from groups P and M had higher flexural strength than other samples. The modulus of elasticity of group SC was statistically lower than that of other groups. The mechanical properties of the materials used to make the occlusal plates differed, and group M achieved the best results in all analyses. Therefore, clinicians must consider the material used to manufacture long-lasting and efficient occlusal splints.

Statement of Problem: Laser phototherapy has been studied as a surface treatment capable of increasing the adhesion of cement to the ceramic surface. However, the bond strength of glass and resin-ceramics after laser phototherapy is unclear., Purpose: The objective of this systematic review and meta-analysis was to compare the bond strength of glass and resin-ceramics using laser therapy and conventional hydrofluoric acid etching., Material and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the Open Science Framework (OSF) for in vitro studies. A population, intervention, control, and outcome (PICO) question was formulated: "Does phototherapy promote better bond strength in glass and resin-ceramics than conventional hydrofluoric acid etching?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases up to January 2023. The Joanna Briggs Institute critical assessment guidelines for quasi-experimental studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (α=.05)., Results: A total of 6 in vitro studies published between 2007 and 2019 with a total number of 348 specimens were included for qualitative analysis; 1 study had a positive effect. Five of the studies were included in the meta-analysis, which indicated a significant decrease for feldspathic ceramics that received laser phototherapy and lithium disilicate (P=.002; MD: -2.15; 95% CI: -3.53 to -0.77; I 2 =89%, P<.01) and (P<.01; MD: -2.13; 95% CI: -2.99 to -1.27; I 2 =82%, P<.01), respectively., Conclusions: Laser irradiation as surface etching of glass ceramics does not produce a bond strength equal to that of conventional hydrofluoric acid etching., (Copyright © 2023 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs)., Material and Methods: An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program., Results: The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29)., Conclusions: The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the adhesion of Streptococcus mutans (S. mutans) on lithium disilicate ceramics, submitted to different intraoral polishing protocols, and the degree of surface smoothness obtained., Materials and Methods: Fifty lithium disilicate specimens were divided into 5 groups (n=10): G1-Glaze Group (positive control); G2-Glaze Group + Wear + Glaze; G3-Wear Group (negative control); G4-Ceramisté Wear Group; G5-Optrafine Wear Group. Surface roughness (Ra - μm) was evaluated and the surface characteristics were assessed using a scanning electron microscope (SEM); to assess S. mutans biofilm, the number of cultured cells was evaluated by counting colony-forming units (CFU/mL). The data underwent one-way ANOVA followed by Tukey's test (P⟨.05)., Results: There was a significant difference in the surface roughness of all groups compared with G3. There was no significant difference between the G4 and G5 groups that received polishing. G1 group had the lowest mean roughness values. There was a difference in Log values (CFU/mL) between the G3 group and the groups that received glaze (G1 and G2). The G3 group had the highest adhesion of S. mutans (4.53 Log)., Conclusion: The most effective polishing protocol after wear is glazing, presenting the lowest roughness and CFU/mL values., (Copyright© 2022 Dennis Barber Ltd.)

Purpose: To develop and to characterize a hybrid interface between yttria-stabilized zirconia (Y-TZP) transformed layer and silica-based nanofilm to enable a better bonding between Y-TZP and a veneering ceramic., Material and Methods: Sixty-six fully-sintered rectangular Y-TZP specimens were distributed into 6 groups, according to the surface treatment applied: C (control): no treatment; Al: 27 μm-alumina particle abrasion; Ht: hydrothermal treatment in autoclave for 15h; Si20: 20 cycles of silica deposition using room-temperature atomic layer deposition (RT-ALD); Si40: 40 cycles of RT-ALD; Ht + Si40: hydrothermal treatment followed by 40 cycles of RT-ALD. RT-ALD was performed by the sequential exposure of specimens to vapor of tetramethoxysilane orthosilicate (TMOS) and ammonium hydroxide (NH 4 OH). Y-TZP surface wettability and shear bond strength (SBS) between Y-TZP and the veneering ceramic were analyzed for all groups after surface treatments. One-way ANOVA and Tukey's HSD test were used for data analysis (p ≤ 0.05)., Results: The highest contact angle was observed for the control group (64.46 ± 6.09 θ), while the lowest values (p < 0.001) were presented after Si20 (29.85 ± 4.23 θ) and Si40 (30.37 ± 5.51 θ) treatments. Hydrothermal treatment (49.3 ± 2.69 θ) and alumina abrasion (45.84 ± 4.12 θ) resulted in intermediate contact angle values. The highest SBS values were observed for Al (16.74 ± 1.68 MPa) and Ht (15.27 ± 2.11 MPa) groups (p < 0.018). Groups Si20 (9.66 ± 1.22 MPa), Si40 (9.33 ± 2.11 MPa), Ht + Si40 (9.37 ± 1.02 MPa) and C (12.54 ± 2.64 MPa) all resulted in similar SBS results (p > 0.998)., Conclusion: The experimental treatments proposed enhanced surface wettability, but shear bond strength between Y-TZP and veneering ceramic was not improved. Alumina particle-abrasion improved SBS values while a decrease in wettability was observed., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective:  The aim of this study is to verify whether removable dentures of patients admitted to an intensive care unit (ICU) are niches of microorganisms that can cause pathologies ( Staphylococcus aureus , Candida spp. , and enterobacteria)., Materials and Methods:  Fifteen patients who were denture wearers (removable partial denture and complete denture) were included in this study. Patients must wear their dentures daily, and these dentures must have acrylic parts. Microbial biofilm was collected from the acrylic part of one denture of each patient. Then, the biofilm was seeded on different culture media: Sabouraud agar, blood agar, MacConkey agar, and mannitol salt agar. In this study, biochemical evaluations of microorganisms were performed., Statistical Analysis:  The percentage of dentures with the microorganism identified by each culture medium was calculated., Results:  In total, 100% of the dentures were positive for Staphylococcus spp. (blood agar) and Candida spp. (Sabouraud agar); 33.3% of the dentures were positive for S. aureus (Mannitol salt agar); and 13.3% of the dentures were positive for Shigella spp. (MacConkey agar)., Conclusion:  Removable dentures of patients (removable partial dentures and complete dentures) admitted to an ICU are niches of microorganisms that can cause pathologies., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Background: To evaluate the stress distribution of three-element prostheses on two different implant systems (External Hexagon (EH) or Morse Taper (MT)) and with two different retention mechanisms (screw-retained or cemented), by photoelastic analysis and strain gauge analyses., Material and Methods: Four photoelastic and 24 strain gauge models of a partially edentulous maxilla were made and were divided in four groups according to connection and retention system: Group I (EH-C) - external hexagon+cement-retained prosthesis; Group II (EH-S) external hexagon+screw-retained prosthesis; Group III (MT-C) - morse taper+cement-retained prosthesis; Group IV (MT-S) - morse taper+screw-retained prosthesis. The implants were installed in the axial position, the first in the region of element 15 and the distal implant in the region of element 17. Loads of 100 N were applied on the occlusal surface of the prosthesis for 10 seconds. For the photoelasticity analysis, photographic images were taken and were evaluated according to the number of high-intensity fringes. For the strain gauge analysis, the strain gauges were positioned on the marginal crest of the implants and on the apical region, being numbered for analysis of the stress distribution in each region. The electrical signals were captured and processed by specific software., Results: Higher concentration of tension was observed in the apical region of the implants and mainly in the distal implant, where the formation of fringes was higher. The microstrain values obtained for each group were similar: EH-C (454±18,3 µɛ); EH-S (469±94 µɛ); MT-C (466±49,8 µɛ); MT-S (460±36,6 µɛ). It was observed that apical position had higher stress concentrations for all analyzed groups., Conclusions: The different connections and fixation mode did not interfere in the amount of tension generated in the tissue adjacent to the implant, also the region that generated the greatest amount of tension was in the apical region of the anterior implant. Key words: Dental implants, biomechanics, fixed prosthodontics., Competing Interests: Conflicts of interest None declared., (Copyright: © 2022 Medicina Oral S.L.)

Objectives: To characterize the surface of zirconia (Y-TZP) submitted to different surface treatments (with and without plasma associations) and to evaluate the shear bond strength (SBS) between veneering ceramic (VC) and Y-TZP after different aging methods., Methods: 301 Y-TZP specimens were fabricated and distributed into 7 groups: C (control): no treatment; Al: airborne abrasion with 27 μm Al 2 O 3 particle; L: liner; P: plasma; Al + L: airborne + liner; Al + P: airborne + plasma; P + L: plasma + liner. The Y-TZP surface was characterized by SEM, EDS, AFM, surface profilometry, surface-free energy (SFE), and XRD. SBS between Y-TZP and VC was verified after three aging protocols: initial, after hydrothermal aging (autoclave for 5 h), or thermal fatigue (30,000 baths - 5-55 °C). One- (profilometry, SFE) and two-way ANOVA (SBS), and Tukey's HSD test were used., Results: For the plasma groups, a full globular surface coverage was observed (SEM, AFM). Si was found for Al, L, Al + L, and P + L. Roughness was lower for C, P, and Al + P. For SFE, the highest values were found when the liner was applied (>74.59 nm/Nm). The highest monoclinic content was observed for Al + L (6.96%) and Al + P (5.86%). For the initial period, Al and P + L presented the lowest SBS values (<5.85 MPa; P > 0.331). The highest SBS values were found for L, P, and P + L (hydrothermal aging) and for P, L, Al + L, and Al + P (thermal fatigue)., Significance: Changes in Y-TZP topography and the SBS with the VC were found, according to treatments performed. Plasma treatment improved SBS and did not cause phase transformation., (Copyright © 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the optical, chemical, and mechanical properties of feldspathic porcelain after handling with different instrument materials., Material and Methods: Feldspathic porcelain was manipulated with different spatula compositions: metal spatula (MS), plastic spatula (PS), and glass spatula (GS) for the fabrication of 30 (n = 10) disks. Contrast ratio (CR), translucency parameter (TP), and surface Knoop microhardness (KHN) were measured. The color change (ΔE 00 ) was evaluated using the CIEDE2000 system. Scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were used for surface analysis. Data were analyzed using one-way ANOVA and Tukey test (P < 0.05)., Results: All groups presented different morphological surfaces with higher presence of Al on the MS. PS group presented lower Al, Si, K than MS, and GS. Higher CR was observed for PS (0.734; P < 0.043), followed by MS (0.696; P < 0.043) and GS (0.65; P < 0.011). The highest TP (13.06) and KHN (386.27) were presented by GS (P < 0.001). MS and PS presented similar KHN results. The higher ΔE 00 were found for plastic/metal comparison. Also, the L * values for the MS group (67.49) were lower than the other groups., Conclusion: The use of metal spatula promoted higher color alteration during feldspathic porcelain manipulation than did the other materials. Handling with glass instrument promoted higher microhardness than other spatula materials., Clinical Significance: The effect of the material used for ceramic handling on feldspathic porcelain properties is often ignored. This study shows that the handling spatula material must be carefully chosen to avoid inadvertent changes to the feldspathic porcelain restoration., (© 2020 Wiley Periodicals LLC.)

Aim: This systematic review with meta-analysis aimed to evaluate the effect of the laser treatment on bond strength between Y-TZP and the resin cement or with the veneering ceramic, and the effect on the alteration of the Y-TZP surface roughness., Settings and Design: Systematic review and meta analysis following PROSPERO guidelines., Materials and Methods: A comprehensive review was performed up to September 2020 on four databases (PubMed/MEDLINE, Embase, Scopus, and Cochrane Library), using the combination of keywords: "laser AND zirconia AND surface treatment AND bond strength"., Statistical Analysis Used: The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. The continuous outcome was evaluated by mean difference and the corresponding 95% confidence intervals., Results: A total of 37 studies were identified for the inclusion of data, with only in vitro studies. The types of laser reported in the studies were: Er:YAG, Nd:YAG, Er,Cr:YSGG, CO2, Femtosecond, and Yb lasers. A random-effect model found statistically significant differences between lasers and control groups of Y-TZP (P < 0.00001; MD: 3.08; 95% CI: 2.58 to 3.58). Only the bond strength with the Er:YAG laser did not present statistical difference (P = 0.51; MD: 0.22; 95% CI: -0.44-0.88). In another analysis, a random-effect model found a statistically significant difference between the laser and control groups on surface roughness (P < 0.00001; MD: 0.96; 95% CI: 0.86 to 1.06)., Conclusions: Laser irradiation is capable to improve the Y-TZP surface roughness and the bond strength of zirconia with resin cement and veneering ceramics. However, there is a lack of laser protocol for the zirconia surface, a fact that makes a simple and direct comparison difficult., Competing Interests: None

Objective: To evaluate the influence of different pigmentations and accelerated aging on the hardness and tear strength of the A-2186 and MDX4-4210 silicones., Materials and Methods: The samples A-2186 and MDX4-4210 were manufactured without and with pigmentations (black, bronze, and pink). For the Shore A hardness test, 80 samples of each silicone were fabricated, and for the tear strength test, 320 samples of each silicone were fabricated. Eight groups were created for each test ( n  = 10). These tests were performed before and after 252, 504, and 1008 hours of aging. Three-way repeated-measures analysis of variance and the Tukey test were performed ( α  = 0.05)., Results: The A-2186 silicone showed higher hardness and tear strength when compared with the MDX4-4210 silicone ( p < 0.05), except in the hardness of the A-2186 and MDX4-4210 groups without pigmentation after 1008 hours ( p > 0.05). All hardness values were between 25 and 35 units, regardless of the silicone type, period, and pigmentation (or no pigmentation). In most situations, the hardness of silicones used increased after 252 hours ( p < 0.05). The nonpigmented MDX4-4210 group and all A-2186 groups showed an increase in tear strength after 252 hours ( p < 0.05). For the nonpigmented MDX4-4210 group, from 252 to 1008 hours, there was no change in tear strength ( p > 0.05). All pigmented MDX4-4210 groups showed no change in tear strength from 0 (initial) to 1008 hours of aging ( p > 0.05). In all A-2186 groups, from 252 to 504 hours, there was a reduction in tear strength ( p < 0.05), and from 504 to 1008 hours, there was an increase in tear strength ( p < 0.05), except in the bronze A-2186 group ( p > 0.05)., Conclusion: In most situations, the A-2186 silicone showed significantly higher values of hardness and tear strength than the MDX4-4210 silicone. All hardness values were considered clinically acceptable. Accelerated aging could increase, decrease, or not significantly change the hardness and tear strength of the silicones used. The results of hardness and tear strength suggest that MDX4-4210 was more influenced by the presence of pigmentation after aging., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Estefânia Marrega Malavazi et al.)

Aim: To evaluate the cytotoxicity and inflammatory response of different types of provisional restorative materials to mice gingival fibroblasts., Methods: Cytotoxicity of provisional material discs (thermal-polymerized acrylic resin; auto-polymerized acrylic resin; bisacrylic resin; nano-ceramic resin for CAD/CAM and prefabricated polymer block for CAD/CAM) to Mice (Balb/c) gingival cell were investigated under direct and indirect contact (extracts) at 24, 48 and 72 h, using the MTT and Alamar blue assays. Materials extracts (24 h) were applied to the cell culture (indirect contact) or cells were seeded on discs of provisional materials, and the cytotoxicity and production of IL-6, IL-1β and TNF-α after 24, 48 and 72 h were analyzed through MTT, Alamar Blue® and ELISA. Culture medium was used as control for indirect contact assay (extract) and the surfaces of the wells without discs of provisional materials were used as control for direct contact assay. Results were analysed statistically by ANOVA followed by the Bonferroni-Test correction. Statistically significant differences were considered if P was < .05., Results: Auto-polymerized and bisacrylic resins (direct contact) reduced cell viability after 24, 48 and 72 h compared to control (P < .05). Indirect contact (extract) was not cytotoxic to cells at all periods compared to control (P > .05). Auto-polymerized and bisacrylic resins increased IL-6, IL-1β and TNF-α levels mainly at 24 h when compared to the other materials (P < .001)., Conclusion: Auto-polymerized and bisacrylic were more cytotoxic to mice gingival fibroblasts. CAD/CAM nano ceramic resin and prefabricated polymer blocks are more predictable materials to preserve the periodontal soft tissues., Competing Interests: Declaration of Competing Interest Manuscript title “Cytotoxicity and inflammatory response of different types of provisional restorative materials” The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Different ceramic surface cleaning methods have been suggested after the acid conditioning. The aim was to evaluate the effect of different protocols used to remove the remaining hydrofluoric acid on the shear bond strength (SBS) between lithium disilicate and resin cement., Material and Methods: Forty-four specimens of lithium disilicate (IPS e.max Press) were divided in 4 groups (n=11): group C (control, no treatment); group HF+S (5% hydrofluoric acid + silane); group HF+US+S (5% hydrofluoric acid + ultrasound cleaning + silane); group HF+PH+S (5% hydrofluoric acid + 37% phosphoric acid + silane). Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were performed to characterize the surface morphology. The SBS test was performed on the resin/ceramic interface, and the failure mode was characterized. SBS values were submitted to 1-way ANOVA and the Tukey test (α=.05). The relation between surface treatment and failure modes was analyzed using the chi-squared test (α=.05)., Results: The surface treatment type interfered in the shear strength ( p <.001) and higher SBS values were observed for the groups HF+US+S (17.87 MPa) and HF+PH+S (16.37 MPa). The surface treatment did not influence the failure mode ( p =.713). No fluorsilicate salts were observed after ultrasound cleaning., Conclusions: The utilization of ultrasound cleaning was an effective procedure to remove remaining fluorsilicate salts, promoting the highest SBS values. Key words: Bond strength, ceramics, fluorsilicate, lithium disilicate, resin cement., Competing Interests: Conflicts of interest The authors have declared that no conflict of interest exist., (Copyright: © 2020 Medicina Oral S.L.)

Objective: To evaluate the long-term color stainability, translucency, and contrast ratio (CR) of different resins used to fabricate interim prostheses after immersion in acidic/staining solutions., Materials and Methods: A total of 160 specimens were divided into 16 groups (n = 10) according to the material (heat-polymerized acrylic resin [HPAR], auto-polymerized acrylic resin [APR], nanoparticulated bis-acrylic resin [BR], and prefabricated poly(methyl methacrylate) block for CAD/CAM [CADR]) and immersion solutions (artificial saliva, cola beverage, coffee, and red wine). A spectrophotometer was used before and after each immersion period (7, 14, 28, 90, and 180 days). Color differences (CIEDE2000 and CIELab) were calculated. A three-way repeated-measures analysis of variance and Bonferroni test (α = .05) were used., Results: After 180 days, the APR presented the highest value for coffee and the CADR presented the smallest value for the cola (P < .001). For the CR, the highest values were obtained at 180 days for BR in coffee (1.35) and wine (1.18) (P < .001). Higher translucency parameters were obtained in the BR and CADR in the initial, 14, 28, and 90 days (P < .001)., Conclusions: From the greatest to the smallest staining potential, the solutions were classified as: wine > coffee > cola beverage > saliva, while for the materials as: APR > BR > HPAR > CADR., Clinical Significance: The knowledge of the long-term optical behavior of interim prosthetic materials is important for clinicians to decide which material to use to match the dietary intake of their patients and their esthetic demands. Prefabricated blocks for CAD/CAM systems have been shown to maintaining their optical characteristics even after a long period of immersion in acidic/staining solutions., (© 2019 Wiley Periodicals, Inc.)

The aim of this study was to develop and characterise a new plasma-enhanced chemical vapor deposition (PECVD) film for improving shear bond strength (SBS) between yttria-stabilised tetragonal zirconia (Y-TZP) and veneering ceramic. In total, 192 Y-TZP samples (13 × 5.4 × 5 mm) were divided into 6 groups: control - no treatment (C), airborne-particle abrasion with 27 μm aluminum oxide particles (Al 27 ), 110 μm aluminum oxide particles (Al 110 ), and 250 μm aluminum oxide particles (Al 250 ), application of liner for zirconia (L) and the PECVD film application (P). The Y-TZP surface was characterised by means of Scanning Electronic Microscopy (SEM), Energy-dispersive Spectroscopy (EDS), atomic force microscopy (AFM), surface profilometry and surface-free energy (SFE). SBS between Y-TZP and veneering ceramic was tested before and after thermocycling (20,000 cycles of 5 and 55 °C), and failure mode was also evaluated. Data were analysed by ANOVA and Tukey's HSD test (α = 0.05). Data analysis showed that PECVD film had no effect on surface roughness of Y-TZP (p > 0.05 vs control), whilst the other groups presented higher roughness values (p < 0.05). All treatments increased SFE, except the Al 27 group. The highest SBS was presented by the P group (p < 0.05), and values were similar to those of the Al 27 group (p = 0.107). Mixed failures were prevalent in all groups, and premature failures were found only in Al groups after thermocycling. Whilst PECVD treatment did not affect Y-TZP surface roughness, high SBS between Y-TZP and the veneering layer was observed. Therefore, PECVD treatment is a promising alternative to improve the performance of bi-layer zirconia-based restorations., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Purpose: The objective of this systematic review with meta-analysis was to evaluate surface treatment in yttria-stabilized tetragonal zirconia polycrystal ceramic (Y-TZP) on the shear bond strength (SBS) values between Y-TZP (core ceramic) and veneer ceramic, compared to untreated specimens., Materials and Methods: This review was registered at PROSPERO platform under the number CRD42016036493. The systematic review of the extracted publications was performed to compare the effect of surface treatment on SBS between Y-TZP ceramic and veneering ceramic. A comprehensive review of the literature from the earliest available dates through January 2017 was performed in the PubMed/Medline, Embase, Scopus, and Cochrane Library databases., Results: A total of 15 studies were identified for the inclusion of data, with only in vitro studies. A random-effect model found statistically significant differences between untreated and treated surfaces of Y-TZP (p < 0.00001; MD: 2.84; 95% CI: 2.19 to 3.49). In another analysis, a random-effect model found statistically significant differences between the groups that only performed the associations of treatments and control group (p < 0.00001; MD: 3.19; 95% CI: 2.11 to 4.28)., Conclusions: Surface treatment in Y-TZP improved the values of SBS between the Y-TZP and veneer ceramic. The associations between two or more treatments also showed positive effect on the bond strength due the cumulative effect of the treatments., (© 2017 by the American College of Prosthodontists.)

In some clinical situations, the clinician may encounter previously installed implants that should be associated with other implants for a proper rehabilitation. The aim of this study was to evaluate the biomechanical behaviour of a multiple prosthesis joined by different implant connections using photoelasticity. Photoelastic models with a screwed fixed prosthesis supported by implants with different connection systems (Morse taper, external hexagon, internal hexagon, and Flexcone), and different combinations among them, were fabricated. Each assembly was placed in a circular polariscope, and axial and oblique (45°) loads of 100 N were applied on the occlusal surface of the crowns. The fringe patterns were photographed and the analysis was performed by counting the number of high-intensity fringes and also according to the stress distribution region where they appeared. Among implants of the same connection, the external connections obtained a greater number of high intensity fringes when compared to the internal connections. From the biomechanical point of view, the association between different types of connections obtained positive results.

Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients' characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient., (Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Statement of Problem: The rehabilitation of patients after a maxillectomy involves the use of an obturator to seal oral-nasal-sinus communication and to facilitate mastication, swallowing, and speech., Purpose: The purpose of this in vitro study was to evaluate different attachment systems used for implant-retained obturators at dissipation loads and under shear forces., Material and Methods: Photoelastic models were fabricated with 3 external hexagon implants at the incisor, canine, and first molar regions. Subsequently, overdentures were made, and metal hooks were placed at the incisor and first molar regions to displace the prostheses in the vertical, anterior, and posterior directions, with a constant speed of 50 mm/min. A photoelastic model with an O-ring or bar-clip system was placed in a circular polariscope, and tested with a universal testing machine. The images were recorded and high-intensity fringes were counted using software. For strain gauge analysis, each strain gauge was placed horizontally at the mesial and distal sides of the implants. The registered strains were submitted to 2-way ANOVA (α=.05)., Results: The O-ring showed the lowest number of high-intensity fringes in photoelastic imaging, while the strain gauge analysis showed the lowest stress values in the bar-clip group (P=.007)., Conclusions: The stress around titanium implant necks was more damaging to surrounding bone, while the bar-clip attachment system had a better biomechanical performance. The bar-clip presented the lowest strain values around the dental implants and few high-intensity fringes., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Short dental implants have been used as an attempt to avoid bone grafts surgery, however there are few literature reports that evaluate changes to their design. Therefore, the aim of this study was to assess the effect of different short implant design on stress distribution through photoelastic analysis. Six external hexagon (5 × 5 mm) short dental implants with different design were used. Each group was treated with a single crown and a three element fixed partial dental prosthesis, resulting in a total of 12 photoelastic models. The assembling photoelastic model-implant-prosthesis was set in a circular polariscope where loads of 100N were applied on the occlusal surface with a Universal Test Machine (UTM). The tension fringes were photographed and later assessed qualitatively by a graphic software (Adobe Photoshop). Less high-intensity fringes were observed on the short implants with triangular threads, short external hexagon and flat apical profile. In conclusion, the macrodesign influenced the amount of stress distributed to the bone when short dental implants are placed.

Purpose: The aim of this study was to assess stress distribution in the bone-implant interface of a mandibular implant-supported prosthesis with different cantilever lengths, aesthetic coating materials, and implant abutments., Materials and Methods: A photoelastic model of an edentulous mandible, containing 5 external hexagon implants, was constructed. Experimental models were divided into 6 groups: group 1-UCLA component and metal bar; group 2-UCLA component and acrylic resin coating; group 3-UCLA component and porcelain coating; group 4-abutment and metal bar; group 5-abutment and acrylic resin coating; and group 6-abutment and porcelain coating. Forces were applied to the most anterior implant, the most posterior implant, and different cantilever lengths., Results: The results showed a higher number of high-stress fringes as the cantilever length increased. Fringes were better distributed in groups with prostheses composed of acrylic resin and in groups that contained an abutment., Conclusion: The stress distribution in the bone-implant interface is improved when the cantilever is eliminated and when abutments in an acrylic resin prosthesis are used.

The material used for interim prostheses fabrication must present excellent physical properties for greater longevity in the face of environmental conditions, which can occur in the oral cavity. The purpose of this study was to evaluate the effect of a photopolymerized glaze on the physical and mechanical properties of polymers used for the fabrication of interim prostheses, before and after thermocycling and immersion in staining solutions. One hundred samples of composite and acrylic resins were fabricated: Dencor chemically activated acrylic resin (CAAR) (n=20) and heat-polymerized acrylic resin (HPAR) (n=20), Charisma (n=20), Structur (n=20), and Protemp (n=20). A mechanical polishing was performed on half of the samples, and a chemical polishing was performed on the remaining samples. Subsequently, all samples were submitted to thermocycling and immersion in coffee staining solution for 21days. Analysis of color and microhardness, as well as atomic force microscopy (AFM), scanning electron microscopy (SEM), and energy dispersive x-ray spectrometry (EDS) were performed. The data were submitted to repeated-measures analysis of variance (ANOVA), followed by the Tukey test (α=0.05) and the Student t-test (α=0.05). It was verified that the glaze decreased the chromatic alteration values, and increased the microhardness values of the samples, with the exception of the Charisma resin. The samples that did not receive chemical polishing had the greatest number of surface irregularities. This study concluded that the groups with glaze presented less color alteration. In addition, Charisma and Structur resins exhibited the greatest chromatic stability. As to the microhardness, the values were greater when the samples were treated with the glaze, with the exception of the Charisma group., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Purpose: This systematic review aimed to evaluate whether the survival rate and predictability of zirconia abutments are similar to those of titanium abutments for single implant crowns in the posterior area., Materials and Methods: A systematic search of two databases (Medline/PubMed and Cochrane Library) was performed by two independent reviewers for articles published between January 2004 and July 2014. The electronic search was complemented by a hand search of the following journals from the same period: Journal of Periodontology, Clinical Oral Implants Research, International Journal of Prosthodontics, and International Journal of Oral and Maxillofacial Implants. Studies included were published in English, evaluated single implant crowns, and performed a mean observation ≥ 1 year. Any disagreement between the reviewers was solved by means of a discussion. Forest plot and funnel were used to compare zirconia and titanium abutments., Results: The search strategy identified 669 studies. Of these, 11 studies were included and only 6 studies were selected for meta-analysis. The pooled results for fixed implant single crowns in posterior areas showed a 5-year success rate of 99.3% for zirconia abutments and 99.57% for titanium abutments. There was no statistical difference regarding veneer failure (P = .26). The pooled results of these studies showed that the mean bone loss was 0.38 ± 0.87 mm for zirconia and 0.2 ± 0.13 mm for titanium abutments., Conclusion: The use of zirconia abutments for single implant-fixed crowns in posterior regions is questionable due to the absence of long-term data. The short-term results of zirconia abutments regarding mechanical and biologic responses are similar to titanium abutments. Caution when using zirconia abutments in posterior regions is necessary until further clinical evidence shows favorable long-term results.

Photoelastic analysis was used to evaluate the biomechanical behaviour of implant-supported, double-screwed crowns with different connection systems and cantilever lengths. Three models were made in PL-2 photoelastic resin and divided into six groups, on the basis of the implant connection system (external hexagon [EH] or Morse taper [MT]), type of abutment (Mini Pilar [Neodent, Curitiba, Paraná, Brazil] or "UCLA") and number of crowns in the cantilever (one or two). The implant-prosthesis unit was placed in a circular polariscope. Occlusal surfaces of the crowns were subjected to 100-N loads in the axial and oblique (45°) directions in a universal testing machine (EMIC). Generated stresses were recorded and analysed qualitatively in a graphics program (Adobe Photoshop). Under axial loading, all of the groups had similar numbers of fringes, which were increased when the crowns were subjected to oblique loading. The highest number of fringes was found during oblique loading in the EH + Mini Pilar group. In conclusion, although the type of implant connection system did not have a direct influence on the stress distribution for axial loading, the cantilever length did have a direct influence on stress distribution. Models with two crowns in the cantilever showed more stress, with a greater concentration of force on the cervical part of the implant.

Objectives: The aim of this study was to assess the flexural strength of two brands of thermopolymerisable acrylic resins (Onda Cryl, Artigos Odontológicos Clássico Ltda, São Paulo, SP, Brazil; and Lucitone 550, Dentsply, York, PA, USA) with varying concentrations of pigment (Poli-Côr, Artigos Odontológicos Clássico Ltda, São Paulo, SP, Brazil) under the influence of thermocycling, storage and disinfection., Material and Methods: A total of 210 samples were manufactured (105 for each acrylic resin brand), with dimensions of 64 x 10 x 3.3 mm. The samples were divided into 30 subgroups (n = 7) according to the proportion of pigment used (without pigment, 3% and 7%), the assessment period (initial or thermocycling for 2000 cycles) and disinfection method (immersion in 1% sodium hypochlorite, (Apothicário, Araçatuba, SP, Brazil), microwave energy or immersion in alkaline peroxide (Efferdent, Pfizer, Morris Plains, NJ, USA). The samples were submitted to the flexural strength test before and after thermocycling, and after storage with disinfection. The disinfection process was performed every 3 days, for 60 days. Data were submitted to analysis of variance (ANOVA) and Tukey test (p < 0.05)., Results: The factors that provided statistical alteration in flexural strength values were resin type and assessment period. The Onda Cryl resin and the period after disinfection (126 ± 25 MPa) exhibited the higher values of flexural strength., Conclusion: Following disinfection, Onda-Cryl resin exhibited the highest values of flexural strength. All the samples obtained are considered clinically acceptable.

The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient's satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success.

This study examined the electrical activity of the superior (SO) and inferior (IO) orbicularis oculi muscles before and after installing ocular prostheses in patients who had undergone unilateral enucleation. Twelve volunteers requiring prostheses were selected. Their electrical activity was monitored at rest and during normal opening and closing of the eyelids, rapid opening and closing of the eyelids, and squeezing. Data were recorded before and 7, 30, and 60 days after the ocular prosthesis was installed. Two-way analysis of variance was performed to verify whether there were any significant differences between the muscles and periods, and means were compared by Tukey-Kramer honestly significant difference (HSD) tests (P < 0.05). Results from the initial period differed significantly from those after prosthesis installation in all clinical situations. The SO had significantly higher electrical activity levels than the IO in all clinical situations but squeezing. The authors observed the same values during the initial period for the condition of rest (SO 8.42/IO 5.93) and the highest values for the condition of squeezing after 60 days (SO 131.50/IO 117.12). Rehabilitative treatment promoted an increase in the electrical activity of the orbicularis oculi muscles, restoring part of the muscle tone and motor function to muscles of the affected area., (Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was evaluate the biomechanical behaviour of prostheses screwed into conventional (0° angulation) and pre-angled experimental (8, 12 and 20°) external hexagon implants (13 × 4 mm) by photoelastic analysis. Eight casts were made in photoelastic resin. Casts were divided into groups of single crowns or three combined elements. Each unit was positioned in a circular polariscope. By using a universal testing machine, 100 N loads were applied in the axial and oblique (45°) directions to fixed points on the occlusal surfaces of the crowns. Generated stresses were recorded photographically and analysed qualitatively in a graphics program. In single-element prostheses, the number of high-stress fringes increased with increasing implant angle. However, in three-element prostheses, there was no difference in the stress distribution with implant angle, except for the 12° implant that had a higher degree of stress. For the other groups pre-angulation of the implant increases the concentration and intensity of stresses for single prosthesis and has similar stress distribution in three-element fixed prostheses.

Purpose: The mechanical properties of acrylic resins used in intraoral prostheses may be altered by frequent exposure to liquids such as beverages and mouthwashes. This study aimed to evaluate the effect of thermocycling and liquid immersion on the hardness of four brands of acrylic resins commonly used in removable prostheses (Onda Cryl, QC-20, Clássico, Lucitone)., Materials and Methods: For each brand of resin, seven specimens were immersed in each of six solutions (coffee, cola, red wine, Plax-Colgate, Listerine [LI], Oral B), and seven more were placed in artificial saliva (control). The hardness was tested using a microhardness tester before and after 5000 thermocycles and after 1, 3, 24, 48, and 96 hours of immersion. The results were analyzed using three-way repeated-measures ANOVA and Tukey's test (p < 0.05)., Results: The hardness of the resins decreased following thermocycling and immersion in the solutions. Specimens immersed in cola and wine exhibited significant decreases in hardness after immersion for 96 hours, although the greatest significant decrease in hardness occurred in specimens immersed in LI. However, according to American Dental Association specification 12, the Knoop hardness of acrylic resins for intraoral prostheses should not be below 15. Thus, the median values of superficial hardness observed in most of the acrylic resins in this study are considered clinically acceptable., Conclusions: The microhardness of polymers used for intraoral prostheses decreases following thermocycling. Among specimens immersed in beverages, those immersed in cola or wine experienced the greatest decrease in microhardness. Immersion of acrylic resins in LI significantly decreased the microhardness in relation to the initial value. Among the resins assessed, QC-20 exhibited the lowest initial hardness., (© 2014 by the American College of Prosthodontists.)

Introduction: The goal of implant treatment is the formation of a direct bone-implant interface contact., Purpose: This study aimed to evaluate the possibilities of immediate loading treatment for edentulous patients rehabilitated with mandibular and maxillary overdentures., Material and Methods: A literature review using the PubMed and BIREME databases between the periods of 1977 and 2011 was performed., Results: From an initial yield of 218 titles, 78 articles were selected for text analysis, finally resulting in 23 studies (16 prospective, 6 prospective randomized, and 1 prospective multicenter) that met the inclusion criteria., Conclusion: The immediate loading protocol through which the implants are subjected to occlusal function immediately after their placement was introduced to overcome this limitation.

Purpose: This study investigated the biomechanical behavior of screwed partial fixed prosthesis supported by implants with different diameters (2.5 mm; 3.3 mm and 3.75 mm) by using a photoelastic analysis., Materials and Methods: Six photoelastic models were fabricated in PL-2 resin as single crowns or splinted 3-unit piece. Models were positioned in a circular polariscope and 100-N axial and oblique (45 degrees) loads were applied in the occlusal surface of the crowns by using a universal testing machine (EMIC). The stresses were photographically recorded and qualitatively analyzed using a software (Adobe Photoshop)., Results: Under axial loading, the number of fringes was inversely proportional to the diameter of the implants in the single crown models. In the splinted 3-unit piece, the 3.75-mm implant promoted lower number of fringes regardless of loading area application. Under oblique loading, a slight increase of fringes number was observed for all groups., Conclusion: The standard implant diameter promoted better stress distribution than the narrow and mini diameter implants. Additionally, the splinted crowns showed a more uniform stress distribution.

The goals of treatment with ocular prostheses are to restore facial aesthetics and self-esteem to anophthalmic patients. Fabricated in acrylic resin, artificial eyes should be aesthetically pleasing, scratch-resistant, and adequately polished. Use of a prosthesis without such characteristics can lead to psychological damage, as well as infection and inflammation due to the accumulation of microorganisms and other substances on an irregularly shaped prosthesis. The present literature review describes the different techniques for fabricating ocular prostheses. Reproduction of the iris color and color stability are important factors that promote adequate aesthetics. The fabrication of an individual ocular prosthesis in acrylic resin provides satisfactory aesthetic results because the impression process establishes the defect contour. Additionally, the iris and sclera can be individually characterized. As the techniques, materials, and manufacturing methods for ocular prostheses continue to evolve, the aesthetics and functionality of prostheses will also improve.

In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC--splinted implants with a bar connected to two centrally placed O-rings, and BOD--splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.

Because the biomechanical behavior of dental implants is different from that of natural tooth, clinical problems may occur. The mechanism of stress distribution and load transfer to the implant/bone interface is a critical issue affecting the success rate of implants. Therefore, the aim of this study was to conduct a brief literature review of the available stress analysis methods to study implant-supported prosthesis loading and to discuss their contributions in the biomechanical evaluation of oral rehabilitation with implants. Several studies have used experimental, analytical, and computational models by means of finite element models (FEM), photoelasticity, strain gauges and associations of these methods to evaluate the biomechanical behavior of dental implants. The FEM has been used to evaluate new components, configurations, materials, and shapes of implants. The greatest advantage of the photoelastic method is the ability to visualize the stresses in complex structures, such as oral structures, and to observe the stress patterns in the whole model, allowing the researcher to localize and quantify the stress magnitude. Strain gauges can be used to assess in vivo and in vitro stress in prostheses, implants, and teeth. Some authors use the strain gauge technique with photoelasticity or FEM techniques. These methodologies can be widely applied in dentistry, mainly in the research field. Therefore, they can guide further research and clinical studies by predicting some disadvantages and streamlining clinical time.

Purpose: In order to assist in the selection of artificial teeth for complete dentures, this study aimed to assess the relationship between horizontal and vertical measurements of the face and the morphology of the maxillary central incisor., Materials and Methods: This was a study of 50 plaster casts and 100 teleradiographs - 50 in lateral norm and 50 in frontal norm, belonging to 50 individuals, Caucasian, with a naturally optimal occlusion, matching at least four of the six keys of Andrews. Images of the upper central incisors were obtained by scanning the plaster casts (three-dimensional) and subjectively classified by three examiners as oval, triangular or quadrangular. Facial measures (vertical and horizontal) were defined by means of teleradiographs. In order to check inter-examiner agreement on the classification of central incisor, the Kappa test was used. To verify whether data had normal distribution, the Kolmogorov-Smirnov test was used (P > 0.2) was used. One-way analysis of variance was employed to assess the association between variables (P > 0.05)., Results: When vertical measurements were compared with the three incisor shapes, there was no statistically significant difference (P > 0.05): Triangular (0.54), oval (0.63) and quadrangular (0.51). Similarly, no difference (P > 0.05) was found for facial width (139.08, 143.37, 141.65), maxillary width (76.68, 78.99, 76.91) and mandibular width (103.47, 105.50, 103.11)., Conclusions: The majority of cases showed that horizontal and vertical measurements of the face cannot be used as a reference for determining the morphology of the maxillary central incisor crown. It is relevant to analyze and compare other morphological structures to improve the oral health-related quality of life for the conventional denture wearer.

The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: "eye amputation," "eye trauma," "phantom eye syndrome," "phantom pain," and "quality of life," associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach.

This study aimed to evaluate the stress distribution through the photoelastic method in implant-retained palatal obturators prostheses. Two photoelastic models with bucco-sinusal communication were fabricated, one model without implants and another with two parallel implants and one tilted in the molar region. A conventional obturator prosthesis and five implant-retained obturators dentures with different attachment systems were fabricated: OR, three individualized O-rings; BC, bar clip; BOC, implants splinted by bars associated with two O-rings positioned at the center of the bar; OD, implants splinted by bars associated with two O-rings positioned in distal cantilever; and BOD, implants splinted by bars with clips associated with two O-rings positioned in distal cantilever. Each assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a load of 100 N was applied on each implant. The results were obtained by observing the photographic record of the tensions in the photoelastic models resulting from the application of load. It can be observed that a larger amount of stress fringes on BC system. It was concluded that the attachment system has a direct influence on the stress distribution of implant-retained obturator prostheses, with the three individualized O-rings exhibiting the lowest stress values, and tilted implants presented a biomechanical behavior similar to parallel implants.

Head and neck tumors are a major health concern worldwide, due to their high incidence and mortality rates, particularly in developing countries. In Brazil, this type of cancer is commonly diagnosed and studies suggested that it may be the leading cause of mortality in the country. The increase in life expectancy worldwide, as well as environmental and behavioral factors, are related to carcinogenesis. Therefore, an understanding of basic epidemiology and statistical methods is critical, in order to promote early diagnosis and cancer prevention. Cancer patients with an indication for prosthesis were selected from the medical records of the Oral Oncology Center, School of Dentistry, São Paulo State University (UNESP), Araçatuba, between 1991 and 2010. The following variables were recorded: gender, age, type and location of the lesion, radiation dose and dental prosthesis. The majority of the patients were male (74.15%) and >60 years of age (53.37%). Tumors were most commonly located in the floor of the mouth (11.1%) and squamous cell carcinoma was the most prevalent type (72.8%). This study provides the profiles of patients who attended the Oral Oncology Center and the results may aid in the creation of cancer prevention programs.

Maxillary defects resulting from cancer, trauma, and congenital malformation affect the chewing efficiency and retention of dentures in these patients. The use of implant-retained palatal obturator dentures has improved the self-esteem and quality of life of several subjects. We evaluate the stress distribution of implant-retained palatal obturator dentures with different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus-nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge (incisive, canine, and first molar regions) and the other did not receive implants. Afterwards, a conventional palatal obturator denture (control) and two implant-retained palatal obturator dentures with different attachment systems (O-ring; bar-clip) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine, and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using a software (Adobe Photoshop). The bar-clip system exhibited the highest stress concentration followed by the O-ring system and conventional denture (control). Images generated by the photoelastic method help in the oral rehabilitator planning.

Ocular prostheses are important determinants of their users' aesthetic recovery and self-esteem. Because of use, ocular prostheses longevity is strongly affected by instability of the iris color due to polymerization. The goal of this study is to examine how the color of the artificial iris button is affected by different techniques of artificial wear and by the application of varnish following polymerization of the colorless acrylic resin that covers the colored paint. We produce 60 samples (n = 10) according to the wear technique applied: conventional technique without varnish (PE); conventional technique with varnish (PEV); technique involving a prefabricated cap without varnish (CA); technique involving a prefabricated cap with varnish (CAV); technique involving inverted painting without varnish (PI); and technique involving inverted painting with varnish (PIV). Color readings using a spectrophotometer are taken before and after polymerization. We submitted the data obtained to analyses of variance and Tukey's test (P < 0.05). The color test shows significant changes after polymerization in all groups. The PE and PI techniques have clinically acceptable values of ΔE, independent of whether we apply varnish to protect the paint. The PI technique produces the least color change, whereas the PE and CA techniques significantly improve color stability.

Background: Ocular prosthesis materials should have specific properties for their indication and durability; therefore, it is important to investigate their physical behaviour when affected by several disinfectants., Objectives: This study evaluated the influence of different disinfecting solutions on the microhardness and surface roughness of acrylic resins for ocular prosthesis., Materials and Methods: Fifty samples simulating ocular prostheses were fabricated with N1 resin and colourless resin and divided (n = 10) according to the disinfectant used: neutral soap, Opti-free, Efferdent, 1% hypochlorite (HYC) and 4% chlorhexidine (CHX). Samples were stored in saline solution at 37°C and disinfected during 120 days. Both microhardness and roughness were investigated before, after 60 days and 120 days of disinfection and storage. Microhardness was measured using a microhardner and the roughness with a roughness device., Results: N1 resin showed lower microhardness when compared with colourless resin (p < 0.05). HYC and CHX groups exhibited the highest change of microhardness and roughness values (p < 0.05). An increase in roughness and reduction in microhardness of ocular acrylic resins were observed after both periods of disinfection and storage (p < 0.05)., Conclusion: Both disinfection/storage periods affected the microhardness and roughness values of the samples., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)